It's hard to find a really nuanced take on psychotropic drugs these days. TV ads try to convince you that meds will transform your life from horrible to awesome (cf. the current Abilify commercial, in which a woman describes her bipolar disorder while wandering a lonely beach, then returns home to bask in the embrace of the man Abilify apparently helped her catch). On the other side, an increasing number of naysayers (backed up by disturbing but conflicting evidence) warn that Prozac leads not only to suicide but to the decline of Western civilization. This month, a middle ground opens up in, of all places, Elle magazine, where author Cathi Hanauer details her complex experience with Celexa. Her piece hits some false notes, but it also points out what's potentially the worst side effect of SSRIs: complacency.Lots of anti-antidepressant screeds quickly admit that, of course, really mentally ill people should take medicine, but that the rest of us should just suck it up and deal with our feelings. This stance is wrong-headed because it fails to understand mental illness as a spectrum and instead assumes that everyone who takes drugs is either 100% batshit or an overprivileged sissy. Hanauer takes a better approach, viewing SSRI treatment as a matter of costs and benefits. For her, Celexa had both. It did in fact, make her feel awesome — she slept better, yelled less, and even finished a novel. But it also made her complacent — "I felt good and didn't want anything to change, to potentially alter my high" — and smug — "if you're so tortured, I'd think, stop whining and medicate!" Hanauer acknowledges that the second cost may be a widespread one. She says she finds her Celexa-smugness "sobering, especially given the number of Americans now on these meds. Compassion is not something we want to lose on a large scale." But she considers only the personal side effects of her complacency, noting that most of the important and beneficial changes in her life came from dissatisfaction. She never makes the next logical step: most important changes in the world come from dissatisfaction too. Medication can be an important tool in the treatment of mental illness, but the relief it brings can distract doctors, patients — and policymakers — from problems that still exist. Being poor makes you more likely to get mental illness; so does being a veteran. And so, I suspect, does living in a country that cares as little for its poor and sick as ours does. So while drugs can do wonders — especially for those who can afford them — we need to remember that depression and anxiety come from the world as well as the brain, and that the world needs fixing too. Club Med [Elle]